Hearing Voices Movement

The Hearing Voices Movement is the name used by organisations and individuals advocating the "hearing voices approach",[1] an alternative way of understanding the experience of those people who "hear voices". In the medical professional literature, ‘voices’ are most often referred to as auditory hallucinations or ‘verbal’ hallucinations. The movement uses the term ‘voices’ which, it feels, is a more accurate and ‘user-friendly’ term.

The movement challenges the notion that to hear voices is necessarily a characteristic of mental illness. Instead it regards hearing voices as a meaningful and understandable, although unusual, human variation. It therefore rejects the stigma and pathologisation of hearing voices and advocates human rights, social justice and support for people who hear voices that is empowering and recovery focussed [3][4] (see the Melbourne Hearing Voices Declaration). The movement thus challenges the medical model of mental illness, specifically the validity of the schizophrenia construct.[5]

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The international Hearing Voices Movement is a prominent mental health service-user/survivor movement that promotes the needs and perspectives of experts by experience in the phenomenon of hearing voices (auditory verbal hallucinations). The main tenet of the Hearing Voices Movement is the notion that hearing voices is a meaningful human experience

The Hearing Voices Movement [6] was established in 1987 by Romme and Escher, both from the Netherlands, with the formation of Stichting Weerklank (Foundation Resonance), a peer led support organisation for people who hear voices. In 1988, the Hearing Voices Network was established in England with the active support of Romme.[7] Since then, networks have been established in 29 countries including Australia, Austria, Belgium, Bosnia, Canada, Denmark, England, Finland, France, Hungary, Germany, Greece, Ireland, Italy, Japan, Kenya, Palestine, Malaysia, New Zealand, Netherlands, Norway, Northern Ireland, Scotland, Sweden, Switzerland, Tanzania, Uganda, USA and Wales.[8]

In 1997, a meeting of voice hearers, family members and mental health workers was held in Maastricht, Netherlands to consider how to organise internationally further research and work about the subject of voice hearing. The meeting decided to create a formal organizational structure to provide administrative and coordinating support to the wide variety of initiatives in the different involved countries.

The organisation is structured as a network and is called INTERVOICE (The International Network for Training, Education and Research into Hearing Voices). INTERVOICE was incorporated in 2007 as a non-profit company and charity under UK law. The president is Maris Romme and the governing body is made up of people who hear voices and mental health professionals.

INTERVOICE hosts the annual World Hearing Voices Congress and an annual World Hearing Voices Day held on the 14th September. It has an international research committee, encourages and supports exchanges and visits between member countries, the translation and publication of books and other literature on the subject of hearing voices.

INTERVOICE is supported by people who hear voices, relatives, friends and mental health professionals including therapists, social workers, nurses, psychiatrists and psychologists. INTERVOICE members believe that the most important factor in the success of their approach is the importance placed on the personal engagement of the people involved, meaning that all participants are considered an expert of their own experience.Membership

The Hearing Voices Movement regards itself and is regarded by others as being a post-psychiatric organisation.[9][10] It positions itself outside of the mental health world in recognition that voices are an aspect of human difference, rather than a mental health problem. One of the main issues of concern for the Hearing Voices Movement is human rights.

The Hearing Voices Movement also seeks holistic health solutions to problematic and overwhelming voices that cause mental distress. Based on their research,[11] the movement espouses that many people successfully live with their voices. In themselves voices are not seen as the problem. Rather it is the relationship the person has with their voices that is regarded as the main issue.[12][13]

The Hearing Voices Movement is actively developing interventions for mental health practitioners to support people who hear voices and are overwhelmed by the experience [14][15][16]

Hearing voices is experienced by many people who do not have symptoms that would lead to diagnosis of mental illness.

Hearing voices is often related to problems in life history.

If hearing voices causes distress, the person who hears the voices can learn strategies to cope with the experience. Coping is often achieved by confronting the past problems that lie behind the experience.

The work of Romme, Escher and other researchersl[18][19][20][21][22][23] provides a theoretical framework for the movement. They find that:

Not everyone who hears voices becomes a patient. Over a third of 400 voice hearers in the Netherlands they studied had not had any contact with psychiatric services. These people either described themselves as being able to cope with their voices and/or described their voices as life enhancing.[24]

Demographic (epidemiological) research carried out over the last 120 years provides evidence that there are people who hear voices in the general population (2% - 6%) who are not necessarily troubled by them [25][26][27][28][29]). Only a small minority fulfil the criteria for a psychiatric diagnosis and, of those, only a few seek psychiatric aid.[30] indicating that hearing voices in itself is not necessarily a symptom of an illness.[31] Even more (about 8%) have peculiar delusions and do so without being ill.

People who cope well with their voices and those who did not, show clear differences in terms of the nature of the relationship they had with their voices.[32]

People who live well with their voice experience use different strategies to manage their voices than those voice hearers who are overwhelmed by them.[33][34]

70% of voice hearers reported that their voices had begun after a severe traumatic or intensely emotional event,[35][36][37][38] such as an accident, divorce or bereavement, sexual or physical abuse, love affairs, or pregnancy.[39] Romme and colleagues found that the onset of voice hearing amongst a patient group was preceded by either a traumatic event or an event that activated the memory of an earlier trauma.[40][41]

Specifically, there is a high correlation between voice hearing and abuse.[42] These findings are being substantiated further in on-going studies with voice hearing amongst children.[43][44]

Some people who hear voices have a deep need to construct a personal understanding for their experiences and to talk to others about it without being designated as mad.

Organization – The need to find meaning, arrive at some understanding and acceptance. The development of ways of coping and accommodating voices in everyday living. This task may take months or years and is marked by the attempt to enter into active negotiation with the voice(s).

Stabilisation – The establishment of equilibrium, and accommodation, with the voice(s), and the consequent re-empowerment of the person.

The Hearing Voices Movement disavows the medical model of disability and disapproves of the practises of mental health services through much of the Western World, such as treatment solely with medication.[48] For example, some service users have reported negative experiences of mental health services because they are discouraged from talking about their voices as these are seen solely as symptoms of psychiatric illness.[49][50][51][52] Slade and Bentall conclude that the failure to attend to hallucinatory experiences and/or have the opportunity for dialogue about them is likely to have the effect of helping to maintain them.[53]

In Voices of Reason, Voices of Insanity, Leudar and Thomas review nearly 3,000 years of voice-hearing history, including that of Socrates, Schreber, and Janet's patient 'Marcelle', amongst others.[54] As with Smith [55] and Watkins[56] they argue that the Western World has moved the experience of hearing voices from a socially valued context to a pathologised and denigrated one. Foucault has argued that this process can generally arise when a minority perspective is at odds with dominant social norms and beliefs.[57]

Downs J. (Ed), (2001) Starting and Supporting Voices Groups, A Guide to setting up and running support groups for people who hear voices, see visions or experience tactile or other sensations. Hearing Voices Network, Manchester, England

Treatment of Schizophrenia Challenged In Western Australia The NewsMaker (Australia) 9 June 2011, "The Psychiatrist, the psychologist and the ex patient: a frank discussion on schizophrenia" Dr Dirk Corstens from the Netherlands, award-winning psychologist Eleanor Longden, and ex patient and Voices advocate Ron Coleman, discuss their expertise and experience on schizophrenia and voice hearing, as well as share innovative ways on the treatment of schizophrenia and management the experience.

Downs J. (Ed), (2001) Starting and Supporting Voices Groups: A Guide to setting up and running support groups for people who hear voices, see visions or experience tactile or other sensations. Hearing Voices Network, Manchester, England

Siegel, Ronald: Fire in the Brain: Clinical Tales of Hallucination Dutton Books New York 1992 Sidgewick H.A. (1894)Report on the census of hallucinations, Proceedings of the Society of Psychical Research, No. 26, pp. 25–394

Slade P.D. (1993) Models of Hallucination: from theory to practice in David, A..S and Cutting, J. (Eds.) The Neuropsychology of Schizophrenia; Earlbaum, London

Beavan, V. & Read, J. (2010). Hearing voices and listening to what they say: The importance of voice content in understanding and working with distressing voices. Journal of Nervous and Mental Disease, 198(3), 201-205.

^Psychological trauma and psychosis: another reason why people diagnosed schizophrenic must be offered psychological therapies. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 31, 247-268.